Etomidate - a review of robust evidence for its use in various clinical scenarios

Erdoes, Gabor; Basciani, Reto; Eberle, Balthasar

doi:10.1111/aas.12289

Cited by 39 publications

(30 citation statements)

References 87 publications

(126 reference statements)

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“…Etomidate was introduced into clinical practice in 1972, and initial reports of its use in humans emerged in the clinical literature soon afterward [ 19 ]. Etomidate is the only imidazole among the general anesthesia induction drugs, and it has the most favorable therapeutic index for single bolus administration [ 4 , 6 ]. Etomidate induces less apnea than barbiturates or propofol, does not cause histamine release, and very rarely causes allergic reactions [ 5 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…It is safe and especially suitable for patients with coronary heart disease, hypertension, old age, or shock [ 1 , 2 ]. Etomidate is an intravenous induction agent that is associated with hemodynamic stability following administration [ 3 , 4 ]. Compared with propofol, etomidate shows greater hemodynamic stability after induction of anesthesia, and may be preferred over propofol for general anesthesia [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Effects of continuous infusion of etomidate at various dose rates on adrenal function in dogs

Qin

Cao

2015

BMC Anesthesiol

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BackgroundEtomidate is a commonly used sedative in intravenous anesthesia. The aim of this study was to compare the effects of various etomidate doses administered by continuous infusion on adrenal function in dogs under general anesthesia.MethodsThirty-six healthy adult male dogs were randomly divided into six groups. Sodium pentobarbital alone was administered to the control group (group C); five experimental groups (E1, E2, E3, E4, and E5) were also given etomidate at doses of 10, 15, 20, 25, and 30 μg · kg−1 · min−1, respectively, to maintain anesthesia. Heart rate (HR), mean arterial pressure (MAP), and bispectral index (BIS) were monitored. Serum cortisol, aldosterone, adrenaline, and noradrenaline levels were measured, and HR, MAP, and BIS values recorded, before intubation (T0), and at 1 h, 2 h, and 3 h after intubation (T1–3).ResultsCortisol and aldosterone levels in groups E1–5 decreased as the doses and times of continuous infusion of etomidate increased. The cortisol level was significantly decreased compared with baseline at T3 in group E1 and at T1–3 in groups E2–5 (P < 0.05). Compared with the corresponding levels in group C, cortisol levels were significantly lower than T0 values at T3 in group E1 and at T1–3 in groups E2–5 (P < 0.05). The aldosterone level was significantly lower at T3 in group E2 and at T1–3 in groups E3–5 (P < 0.05). Significant reductions in cortisol levels at T2–3 in group E2 and at T1–3 in groups E3–5 compared with group C were also observed (P < 0.05). The plasma adrenaline and noradrenaline levels, HR, MAP, and BIS in groups E1–5 were within the normal range at the different times and with the different doses (P > 0.05).ConclusionsCortisol and aldosterone levels decreased with time and continuous infusion of etomidate; there were no significant changes in adrenaline and noradrenaline levels, HR, MAP, and BIS in any group.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of continuous infusion of etomidate at various dose rates on adrenal function in dogs

Qin

Cao

2015

BMC Anesthesiol

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“…Etomidate is one of the strongest imidazolebased anesthetic agents with quick onset with smallest amount of side effects on respiratory system and pressure of circulating blood with a high satisfactory therapeutic index [24,25]. Etomidate through improving the function of Gamma-Aminobutyric acid (GABA A ) receptors in the brain could produce adequate hypnosis and dependent [26].…”

Section: Analogues Of Etomidatementioning

confidence: 99%

A Review on Novel Progressions in Intravenous (IV) agents for Anesthesia

Zoroufchi

Abdollahpour

2019

JPRI

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One of the main medical proficiencies involved with the procedure of patient’s perioperative care before, during and after operation is anesthesiology. This field of science has made a lot of hopeful progression in detection of new, secure, impressive, and productive procedures for proper management of patients. The most effective sedative–hypnotic agents which categorized in titratable intravenous medication, have highest medicinal effect and the least side effects. Currently a high effort is employed for developing such drugs with central focus on improving the available drugs structures for modifying their pharmacokinetic (PK) and pharmacodynamic (PD) characteristics. Various drugs are investigating for achieving more progression which includes etomidate, midazolam analogues, and diprivan. One of the main approaches for investigating about the development of anesthesia agents is swift screening of related libraries of molecular structure which evaluate phenotypic or structural assays of anesthetic and receptor interactions of agents. Due to the recently high demands of clinical operations for more sufficient anesthesia agents, the progression of anesthetic agents is experiencing a new generation of advanced clinical trials. In this regard, the current study is trying to provide a brief look on the newest anesthetic drugs and novel developed procedures which simplify this objective. This comprehensive study reviews would clarify the novel technology of progression of drugs which do not have physical addiction effects, distinctive system of anesthetic drug delivery, and the novel failures of drugs and their facilities.

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“…AEs associated with the frequently use of analgesics, sedatives, and antipsychotics can affect all organ systems and result in substantial morbidity and mortality [29]. Etomidate is an intravenous (IV) hypnotic and has good clinical profile in haemodynamic high-risk scenarios [30].…”

Section: Cardiac and Circulatory Effectsmentioning

confidence: 99%